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Questionnaire

In order to satisfactorily analyze the wastewater situation at your plant and arrive at
a practical, economical solution, the following information is necessary.
All information will be kept in strictest confidence and will be used only for our
purposes.

Company Date:
Name:
Contact
Person: Position:
Address:
Contact
No.:

Wastewater Parameter
Flowrate Intake (liters/day or cu.m/d
Discharge ( liters/day or cu.m/day
Daily maximum Treated effluent (ppm)
concentration (ppm)
Biological Oxygen Demand (BOD)

Chemical Oxygen Demand (COD)

Total Suspended Solids (TSS)


Oil and Grease
pH
Temperature
Total Coliform
Ammonia Nitrogen
Phosphorus

149 C Bonny Serrano Ave. Brgy Socorro, Quezon City


Tel. Nos.: 0908-8100761, 8921-4953; email : wastewatercleaner.bc@gmail.comb
Heavy Metals (if applicable)
Daily maximum concentration Treated effluent (ppm)
(ppm)
Arsenic - -
Sulfur - -
Chromium - -
Cyanide - -
Lead - -
Mercury - -
PCB - -

Current Treatment Facility

Type of waste water system


Name of tank/chamber L x W x water depth Capacity or volume
according to flow

Energy consumption of the


treatment plant and cost / month
Sludge quantity

Where do you dispose your sludge

Monthly cost of sludge


Handling/disposal

149 C Bonny Serrano Ave. Brgy Socorro, Quezon City


Tel. Nos.: 0908-8100761, 8921-4953; email : wastewatercleaner.bc@gmail.comb
What type of system do you use for
polishing your effluent (ex. UV,
Chlorination, etc)

Major Interest in the Project

What are your main interests in investigating waste treatment at this time?
Please rank 1 – 5, (5 being the highest) in order of importance to you

Reuse of water:

Elimination of sludge disposal:

Elimination of odor:

Elimination of color:

Cost of operation of current system:

Regulatory compliance considerations:

Elimination of surcharges and fines:

Submitted by: Position/Designation

For any questions or concerns you may have, please contact us at wastewatercleaner.bc@gmail.com
or at Tel. Nos. 09088100761

149 C Bonny Serrano Ave. Brgy Socorro, Quezon City


Tel. Nos.: 0908-8100761, 8921-4953; email : wastewatercleaner.bc@gmail.comb

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